Buena Vista County
Organization Active NPI Home Health Agency · Storm Lake, IA
NPI 1639100134 · NPPES record last updated Oct 14, 2021
Key facts
- NPI
- 1639100134
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- BUENA VISTA COUNTY
- Practice address
- 1709 East Richland Street
Storm Lake, IA 50588 - Phone
- (712) 749-2548
- Fax
- (749) 258-2549
- NPI assigned
- Jul 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Julie Sather, BSN
- Title
- Administrator
- Phone
- (712) 749-2548
Owners & managing parties with NPI records 1
Other NPIs with the same Medicare PAC ID 1
Subparts reporting this organization as parent 1
Corporate family (same tax ID) 2
Affiliated clinicians 2
-
Jacqueline Ann Ellison, DNP, ARNP, FNP-C
Medicare Care Compare: Home health agency
- Listed as
- Buena Vista County Public Health and Home Care
- Overall star rating
- ★★☆☆☆ 2 of 5
- Ownership
- Government Operated
- Certified
- Jun 30, 1976
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Home health agency certification: CCN 167081
- Legal name
- BUENA VISTA COUNTY
- Doing business as
- BUENA VISTA COUNTY PUBLIC HEALTH & HOME CARE
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jun 30, 1976
- Last certification
- Apr 4, 2019
- Ownership / control type
- Government Operated
- Organization structure
- Government · Non-profit
- Enrollment address
- 1709 Richland Dr
Storm Lake, IA 50588-3503
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Lacey Anderson |
W-2 Managing Employee |
Jul 1, 2025 | |
| Buena Vista County |
5% Or Greater Direct Ownership Interest | Jun 30, 1976 | 100% |
| Tracy Gotto |
W-2 Managing Employee |
Jun 9, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071228000440 | IA | Part a Provider - Home Health Agency | 3678653862 | Practice locations: Storm Lake, IA |
National Provider Directory
- Tax ID family
- Buena Vista County Community Services
Locations
1709 Richland Dr
Storm Lake, IA 50588
Phone (712) 749-2548
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes | ||
| Public Health or Welfare Agency | 251K00000X |
Addresses
Primary practice location
1709 East Richland Street
Storm Lake, IA 50588
Mailing address
1709 East Richland Street
Storm Lake, IA 50588
Phone (712) 749-2548
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0670810 | Medicaid | IA |
Other names
- Buena Vista County Public Health & Home Care
Other providers in Storm Lake, IA
- Lindsay Ann Brechwald
- Kendra Buchely
- Buena Vista Anesthesia Associates PLC
- Buena Vista Anesthesia Associates PLC
- Buena Vista County
- Buena Vista County Community Services
- Buena Vista Manor Care Center
- Buena Vista Manor, Inc.
- Buena Vista Manor, Inc.
- Buena Vista Regional Medical Center
All providers in Storm Lake, IA · Home Health Agency in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.